FASD Flashcards

1
Q

what is FASD?

A

FASD is a diagnostic term used to describe a broader spectrum of presentations and disabilities resulting from alcohol exposure in utero.

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2
Q

challenging in diagnosing

A
  1. No specific and uniformly accepted diagnostic criteria have been available for facial malformations, growth retardation, CNS abnormalities, confirmation of maternal alcohol consumption
  2. Not all children or older adults with FASD look or act the same
  3. Lack of knowledge and misconceptions among primary care providers, i.e: FASD can only occur if the mother is alcoholic, FASD only occurs among low-income families or other racial and ethnic minority groups
  4. Lack of diagnostic details to distinguish FASD from other similar diseases, i.e: Williams syndrome
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3
Q

diagnosis framework

A
  1. Initial recognition of a child or older individual has a potential FASD. The recognition of developmental problems, facial abnormalities, growth delay can come from the notice of parents, daycare staff, school system
  2. The referral process is initiated at the point a clinician starts to have suspicions of an alcohol-related disorder for a child, the evaluation gathers specific data to diagnostic criteria
  3. FASD diagnosis uses dysmorphic and anthropometric assessment with neurodevelopmental evaluation data. Intervention Plan is developed using a multidisciplinary team approach: physician, child-develop specialist, psychologist, speech-language pathologist
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4
Q

criteria

A
  1. All three facial features: smooth philtrum, thin vermillion border, small palpebral fissure
  2. Growth deficit: confirmed prenatal or postnatal height or weight, or both, at or below 10%, adjusted for age, sex, race or ethnicity
  3. Central nervous system problem, i.e intellectual deficits, cognitive or developmental deficits, executive functioning deficits, motor functioning delays, problem with attention or hyperactive, pragmatic language problems, memory deficits
    ● Maternal alcohol exposure: confirmed or unknown
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5
Q

incidence and causes

A

Caused by drinking during pregnancy
● 1 in every 9 pregnant women between the ages of 18-44 years old drinks during pregnancy
● ⅓ of those women admitted to binge drinking
No Exact number of how many kids get affected by FASD
● Only about 10% of newly born baby’s affected with alcohol, exhibit symptoms and abnormalities

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6
Q

US population

A

● Based on the medical records by CDC, studies have shown that 0.2 - 1.5 out of 1000 babies born has FASD
● Most recent study states that there are only .3 out of 1000 babies have FASD from ages 7-9
In person Studied Identified
● studies in person identified that 6-9 babies out of 1000 will have FASD
● 1-5 per 100 children in school suffers from FASD

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7
Q

Canada population

A

● In Canadian population about 1 out of 1000 babies would be diagnosed to have FASD
● Its estimated that 3,000 canadian babies a year will have FASD
● According to the Government of Canada about 300,000 people in canada is living with FASD
● FASD is a lot more significant in the indigenous population
In Manitoba
● The prevalence of having FASD in Manitoba is about 113 out of 1000 which is 13% higher that estimated in a general population

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8
Q

difficulties

A

● It has been observed that as high as 85% of the people with FASD have sleeping problems
● hearing loss occurs for about 83% of people with FASD
● 67% of FASD children have deficits in attention or is hyper active (ADHD)
● Some people even suffer from difficulty with facial recognition

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9
Q

treatment

A

There is no cure for FASD however…
● Early Intervention Services
● Services that help babies and toddlers with developmental delays or disabilities
● Birth to 3 years old - learn essential skills
○ Physical, cognitive, communication, social/emotional, self help
■ Services such as Speech and language, Physical and
Occupational, Psychological
○ Improves self esteem, self awareness, daily functioning, learning to cope with new situations

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10
Q

protective factors

A
Key to minimize secondary disabilities associated with FASD: 
● Early Diagnosis
● Involvement in special education and social services
● Stable home environment
● Absence of violence
Types of Treatments:
● Medical Care/Medication
● Behavior and Education Therapy
● Parent Training
● Alternative Approaches
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11
Q

importance of protective factors

A

An early diagnosis, and an effective management plan for on-going supports can help
prevent people with FASD from developing secondary disabilities, such as:
● Mental health problems (like depression or obsessive-compulsive disorder);
● Dropping out of, or disrupting, school
● Trouble with the law
● Chronic unemployment
● Alcohol and drug problems; and
● Homelessness.

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12
Q

medical care/medication

A

Same needs as people without FASD
● Vaccinations, good nutrition, exercise, hygiene
Specific concerns that are associated with FASD must be monitored by specialist
● Pediatricians, plastic surgeons, occupation/physical therapist
No specific medication to treat FASD, but can help manage symptoms *Affect every child differently, one might work well and one might not
● Stimulants – hyperactivity, attention spans, poor impulse control
● Antidepressants – sad mood, school disruption, antisocial behaviours
● Neuroleptics – aggression, anxiety
● Anti-anxiety – symptoms of anxiety

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13
Q

behavior and education therapy

A

Good Buddies
● Friendship Training to teach social skills
● Group format; held in 12 sessions
● Child host play date with classmate or peer
Math Interactive Learning Experience
● Deficits in mathematical functioning have been reported consistently among alcohol-affected individuals.
● Improve child’s mathematical knowledge and skill
● One to one tutoring using specifically adapted materials

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14
Q

parent training

A

Children with FASD may not respond to standard parenting practices
● Training can be done in groups or individual families
TIPS
● Concentrating on child’s strengths/talents
● Accepting child’s limitations
● Using specific language; keeping it simple
● Learning with visual aids, music and hands on activities
● Positive reinforcement (praise, incentives)

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15
Q

alternative appraoches

A
  • yoga and exercise

- animal assisted therapy

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16
Q

ranges of severity

A
  1. Fetal alcohol syndrome ( FAS)
  2. Partial fetal alcohol syndrome ( pFAS)
  3. Alcohol related neurodevelopmental disorder (ARND)
  4. Alcohol related birth defects ( ARBD)
17
Q

Fetal alcohol syndrome

A

● Fetal death = most extreme outcome from drinking during pregnancy
● Might have abnormal facial features, growth/central nervous system problems
● Trouble with learning, memory, communication, vision or hearing
● Criteria:
○ Growth deficit: below normal
○ FAS Facial Features: must have all three
■ Smooth philtrum, thin upper lip, wide appearance of eyes
○ CNS damage
○ Confirmed/unconfirmed prenatal alcohol exposure
FAS Facial Feature Ranking:
● Developed by University of Washington
● 5 point Likert Scale with photos
● Normal = 1 Severe = 5
● Ranking facial features is quite complicated

18
Q

Partial fetal alcohol syndrome

A

● Person does not meet full diagnostic for FAS
criteria
● Most, but not all, of the growth deficits and/or
facial features of FAS
● Damage to CNS
● Confirmed prenatal alcohol exposure
● Criteria:
○ Growth Deficit: may range from normal to
deficient
○ FAS facial features: two or three present
○ CNS damage
○ Confirmed Prenatal alcohol exposure

19
Q

alcohol related neurodevelopmental disorder

A
● Diagnostic categorization for individuals who
have:
○ Damage to CNS
○ Confirmed prenatal alcohol exposure
● Intellectual disabilities
● Problems with behaviour and learning
● Might do poorly in school
● Struggle with:
● Math, memory, attention, judgement, and poor
impulse control
20
Q

alcohol related birth defects

A
● Have problems with:
○ Hearing
○ Heart
○ Kidneys
○ Bones
● These features are not criteria for diagnosing FASD
● The Canadian Guidelines suggest ARBD should not be used as an umbrella term or
diagnostic category for FASD
21
Q

symptoms

A

● Inconsistent memory and recall
● Inability to filter out environmental or emotional distractions and sensory stimuli
● Slow and inconsistent cognitive and auditory processing
● Decreased mental stamina
● Difficulty interpreting and applying abstract concepts (for example, managing
money and time)
● Impulsivity and poor judgment
● Inability to predict outcomes (of their own or others’ actions)
● Difficulty shifting from one context to another
● Resistant to change
● Inability to see another person’s perspective
● Inability to recognize indirect social cues

22
Q

teaching and coaching

A
  • Ensure educational environment is modified to the student’s unique needs
  • 5 essential teaching methods
    1. A structured environment
    2. Consistent Routine
    3. Brief Presentation
    4. Variety
    5. Repetition
23
Q

a structured environment

A
  • Teach a few simple rules
  • Concrete rules
  • Write them down
  • Enforce rules in a consistent manner
  • Simplify student notebooks and belongings
  • Use one notebook for each subject
  • Color code dividers for each subjects
  • Keep communication open b/w home and school
  • Include a daily homework sheet in the student’s notebook that requires a parent/guardian signature
24
Q

a consistent rule

A
  • Assign seats
  • Keep these constant throughout the year
  • Post and review the daily schedule
  • Keep schedule predictable and consistent
  • Activities should occur the same time each day
  • Linear clock
  • Review the schedule at the end of the day
  • Prepare students ahead of time for transitions/changes
    from the schedule
  • Recognize the following types of transitions or changes in routine can cause difficulty
  • New student, sub. Teacher, new
    classroom, switching subjects, new skill
  • Provide signals to let students know transition is coming
  • Ring a bell
  • Turn the light switch on and off
25
Q

a brief presentation

A
  1. Brief Presentation
    - Make presentations simple and brief
    - Keep language simple
    - Be explicit and brief
    - Keep concepts concrete
    - Use vocabulary that is familiar to students
    - Multi-step directions are confusing due to sequencing, processing and memory difficulties
    - Break information into small pieces or chunks
    - Give steps one at a time
    - Use pictures or visuals to represent steps
26
Q

use variety

A
  • Use multi-sensory learning
  • Sing songs and use music
  • Drama
  • Puppets
  • Hands on projects
  • Relate learning to student’s life experiences
  • Read a menu, count change,
  • Pretend taking a bus
  • Pair oral information with visual information
27
Q

repetition

A
  • Reteach and reinforce learned concepts
  • Practice
  • Analyze steps of task and break them into small components
  • Use a step-by-step approach
  • Teach steps in the same sequence
28
Q

coaching/ PA considerations

A
  • Involvement in organized team sports may be challenging
  • Hand-eye coordination is poor
  • Poor central/postural stability
  • May cause clumsiness
  • Strengthen upper body
  • static/stationary balance is affected more than dynamic
  • Important to move around the environment to maintain an upright posture
  • Poor body awareness
29
Q

what you can do

A
  • Provide activities to improve balance and coordination
  • Throwing & hitting targets
  • Obstacle courses
  • Stability exercises
  • Physical therapy can be helpful
  • Swimming,
  • Dancing,
  • Gymnastics
  • Cross country skiing
  • Strengthen upper body through the shoulder joints
30
Q

resources

A
  • canFASD
  • manitoba FASD center
  • government of canada